Position your HME business for home modification sales
by Jerry Keiderling

Baby boomers have opened a whole new world of opportunity for providers who wish to stake a claim in the products and services industry—and it’s not all about home medical equipment, although that’s certainly part of it.

Providing independent living solutions for boomers, aging relatives and the physically challenged is a revenue source worth exploring. With the downward 
spiraling reimbursement schedules, increased regulation and mandates, and competitive bidding, accessibility and home modifications are a natural progression for HMEs looking to diversify their product offerings and expand their services to existing clients as well as new customers.

According to the MetLife Mature 
Marketing Institute, 91 percent of pre-retirees ages 50 to 65 want to live in their homes during their retirement years. Aging-
in-place technology has already reached the $2 billion market level, and it is projected to reach $5 billion by 2015. The total market for remodeling for independent living is projected to be $25 billion.

Despite good health intentions, 60 percent of adults between ages 50 and 64 suffer from at least one chronic health condition. Half of these Americans have high blood pressure, which is a major risk factor for heart disease and stroke, and two in five are obese. With the demographics and statistics laid out in front of us, it’s obvious that we’re living longer but not necessarily healthier. That’s where HME providers step in, and it’s also why more HME companies are moving toward the home accessibility business model.

Accessibility and home modifications require a professional who is trained and certified and fully comprehends the types of difficulties individuals experience in their daily lives. The correct products, equipment and environmental improvements can help people live their entire lives in their own homes. While there may be defined sets of product categories, there are not necessarily defined sets of patients with whom to match them.

2-IN-1 Grab Bars & Towel Shelf with grips. Photo courtesy of Lifetime Grabcessories.

Generalities do exist, but a consultative approach by a certified professional is the best route to formulate the right solutions and match products and services to the needs of the client. Presenting a client with valid solutions to existing and potential problems is the best sales tool of all.

An AARP study revealed that 80 percent of those older than age 45 want to remain in their own homes, even when they require assistance. In other words, they want to “age in place.” Another study, by Clarity and the EAR Foundation, showed that older people fear losing independence (26 percent) and moving to a nursing home (13 percent) much more than they fear death (3 percent). Together these studies make our path clear—
anything we can do to help people age in place and retain their independence is the direction our industry is headed.

The aging in place trend isn’t new. People older than age 50 have always been less likely to migrate than those in their twenties and thirties. But Census reports show that the number of older Americans and the median age population of the nation have ballooned and will continue to grow in every corner of the country during the next two decades.

The fastest growth in the 55- to 64-year-old cohort during the past decade occurred in New England and Western states such as Oregon, Arizona and Idaho. Even the state with that group’s slowest projected growth, New York, saw a 33 percent rise.

Why the boom in accessibility and home modifications? The answers pertain to both health and lifestyle. An excerpt from a 2010 issue of The New England Journal of Medicine states that, “ultimately, health care organizations that do not adapt to the home care imperative are taking the risk of becoming irrelevant. It seems inevitable that health care is going home.” With an American turning 50 years old every 7 seconds, that’s more than 12,500 people every day (U.S. Census). That’s a lot of individuals looking to retain their independent and active lifestyles in their own homes.

Many factors lead these individuals 
to want to remain at home—keeping family close, maintaining longtime relationships with neighbors, enjoying comfortable and familiar surroundings, convenience of essential services nearby or holding onto a lifetime of memories with loved ones.

“Settledness” is a common trait found among boomers. They want to stay closely tethered to their suburban homes, close to family, friends, clubs, churches and familiar community surroundings. These ties define what our American communities look like and how they function. For aging boomers and those already retired, the community in which they choose to live and grow older is not just a way station; it’s a lifetime commitment.

To help these ambitions for independence happen, people need to be educated about what and who can help them achieve self-dependence. Much of the progression toward independent living needs to be proactive and future-focused. Certifications, lists and tools designed to help with the home access evaluation can help providers assess needs and work toward a plan of care.

Whether you are a boomer or you are looking to care for a parent, loved one or child, it’s best to look at safety concerns first, because they’re the most important part of an evaluation. Evaluations and assessments can help accident-proof the home before any falls occur. Information gathered in these assessments can be used to formulate a plan for future care. If the specific comfort and safety needs can be met for the clients and their family members, all will see the value and be more proactive about solutions for the future that could involve accessibility equipment and some remodeling projects.

Often during a design evaluation for independent living, the concerns end up being about design and changes to an already comfortable and familiar setting for the client. At this point, it’s been determined that the addition of accessibility equipment and possible structural changes are necessary and are being discussed. Four design strategies should be considered when developing a plan for any client. Funding, compatibility and specific need will help dictate the findings under each concept.

  • Accessible Design—Blends points of Universal Design and specific customer needs
  • Adaptable Design—Where accessible design parameters meet with the real world of your customer’s home
  • Affordable Design—Feasibility assessment of the project addressing circumstances, available funding, start and end dates, etc.
  • Aesthetic Design—Final stage for the customer, family and friends to gauge satisfaction of the changes. This can be a tremendous stumbling block for the customer and for the family.

Whether you’re making simple changes for safety concerns, installing accessibility equipment, improving home entry and exit capabilities, or remodeling bathrooms and kitchens, meeting the needs of the client is of the utmost importance.

Portable ramps provide lightweight safety and strength and offer users a compact travel-safe option. Photo courtesy of EZ-ACCESS.Portable ramps provide lightweight safety and strength and offer users a compact travel-safe option. Photo courtesy of EZ-ACCESS.

Many HME providers have stepped into the accessibility arena and found it to be a positive move for their businesses. There are some common components to a successful operation. The key to developing any prosperous business is distinguishing yourself in the marketplace. Boomers are the target market. They need the products and services you sell, and so do their paents. Getting the right message to your existing clientele and referral sources in an informative fashion is essential. Make your target audience aware of your new service offerings and the specific products that you are carrying to meet their aging needs for today, tomorrow and the future.

Your marketing efforts should, whenever possible, encompass all 
forms of media. While baby boomers trust their doctors most when it comes to health information, market research shows that magazines and the Internet are not that far behind. The boomer generation invented the Internet, and they are more comfortable with new technology than many people give them credit for. This fact alone is a good reason that your website should be attractive, informative and easily located through Web browsers such as Google, Yahoo and Firefox.

In fact, more than 65 out of 78 million baby boomers are active online, making up a full one-third of the 195 million Web users in the U.S. And remember, boomers were the first generation to grow up with TV, so it makes sense that they still prefer this medium as they age. Studies show that boomers, especially the empty nesters, log more than 12 hours per week in front of their televisions. They are more interested in news programs and cable network programs featured on Lifetime, HGTV, History and the Discovery Channel than any reality shows.

Credentialing and training are an absolute because your clientele will rely on your company to be well-informed, expert and professional in your consultations and operations. There are multiple opportunities for product education and dealer certification from most vendors of accessibility products, either at their locations or at your store, depending on the complexity of the equipment and the scope of the training. As far as credentialing goes, several options are available with outstanding track records and comprehensive training programs.

The Certified Aging in Place Specialist certification, available through the National Association of Home Builders, is very popular within the contractor/remodeling industry. The Certified Environmental Access Consultant, available through the Accessible Home Improvement of America network, is positioned as the credential of choice for HME/
accessibility providers. When combined in a working relationship between the provider and remodeler, the results are unmatched. The end outcome is a complete understanding of client needs and the project proposal, where only the best of final products can be expected.

As a new division of your company, accessibility and home modification becomes a mixture of expertise aimed at providing the best possible solutions for your clients. As an HME provider, your experience and expertise are centered on the client and their circumstances or diagnosis. Your knowledge of their capabilities and difficulties now and in the future must be paired with the available assistive devices and equipment on the market and your knowledge of funding and available resources.

The HME provider has options for adding the construction trade to the mix when it comes to expertise on the remodeling side of this issue. Depending on the intended and proposed business model, several scenarios have proven to be very successful. One option is to form a working relationship with a qualified and licensed contractor/remodeler. Another is to hire a contractor, bringing him into the company as an employee. This approach brings the value of having full control of all business and projects under one roof. This can be very helpful when dealing with multiple trades, striving to meet timelines and juggling schedules to meet the needs of clientele. Either way, having both HME and remodeling specialties at hand and ready to perform is imperative.

In June 2009, the Department of Health and Human Services developed the Administration for Community Living program to coincide with the Community Living Initiative, and to promote programs and operations that will help keep aging and physically challenged individuals in their homes rather than moving them to care facilities. The true basis for this endeavor is simply dollars and cents.

A study performed by the MetLife Mature Market Institute clearly shows a dramatic cost savings to insurers and consumers when comparing in-home care and services to that of facility care. Using $10,000 as a sample cost for basic structural modifications compared to assisted living costs at $3,000 or more per month, a simple equation shows that avoiding those costs for a little more than three months will pay for home modifications. It’s quite obvious why health care in the U.S. is headed home.

The sheer size of the baby boomer market has opened a wealth of opportunity for HME providers who are interested in involvement in the products and services industry.

Providers who are willing to develop the accessibility and home modification side of their businesses can gain profit and unending opportunity through providing independent living solutions for boomers, their aging relatives and the physically challenged. The home accessibility market is a revenue source that is definitely worth exploring.

General Safety Concerns

General Safety

  • Place frequently used items within reach.
  • Install or inspect smoke alarms and CO2 detectors.
  • Check that small appliances are working properly—toasters, space heaters, blenders, coffee makers, 
microwaves, etc.
  • Remove chairs with casters/rollers on the legs.
  • Install and use a cordless phone or cellphone that 
individuals can carry around with them.
  • Program all emergency and important contacts into 
cell or wireless phone systems, and post all emergency numbers near the phone or in convenient places.
  • Install a call-button system that alerts authorities immediately in case of emergency.
  • Reduce incoming phone calls to the home—add the home phone number to the Do Not Call Registry by calling 1-888-382-1222 or visiting donotcall.gov.

Safe Mobility

  • Remove clutter from main traffic areas.
  • Remove potential tripping hazards such as electric cords, low-lying furniture, area rugs and loose carpet.
  • Inspect and repair walkways and driveways.
  • Install ramps outside and inside the home.
  • Even out differences in floor heights from room to room by installing beveled thresholds.
  • Inspect hand rails for proper, secure installation to 
ensure they can support appropriate weight.
  • Position furniture to allow plenty of space for walking.
  • Check stairways to ensure treads are secure, carpeting is not loose or worn, riser heights are even, protruding nails are removed and handrails are secure.
  • Replace handles on doors, cabinets and furniture.
  • Verify that footwear worn in the home has non-skid soles for better friction.

Room-to-Room Improvements

Bathroom Safety

  • Install non-skid surfaces on the floors, shower and tub.
  • Install grab bars near the toilet and tub.
  • Install elevated toilet seats with armrests.
  • Keep shower and tub chairs accessible.
  • Install a raised toilet or toilet seat for easy transferring.
  • Replace faucet fixtures with easy-to-use style.
  • Set water heater at 120 degrees or lower to avoid scalding temperatures.
  • Store away all sharp objects (razors, knives, scissors).
  • Label cleaning products for easy identification and use.

Bedroom Safety

  • Move furniture with sharp corners or edges away from the bed in case of a fall.
  • Move breakable items away from the bed.
  • Install adjustable bed rails on the bed to keep a person in bed and aid in getting in or out; standing poles can also be installed.
  • Store a flashlight near the bed.
  • Raise/lower the bed height to make getting in and out of bed easier.
  • Remove all sources of flame from the bedroom.

Closet Safety

  • Rid the closet of any excess items of clothing.
  • Use adjustable rods and shelves.
  • Move shoes off of the floor and into a shoe rack.
  • Install extra lighting.
  • Remove items that might tip over or fall.

Medicine Safety

  • Organize medicine in daily dosage packs to prevent 
errors in medication consumption.
  • Dispose of expired prescriptions and unmarked bottles.
  • Keep all medications in original containers.
  • Refill prescriptions far enough in advance to avoid running out of medication.
  • Store all medicine in a secure location.
  • Ask pharmacist for non-child-resistant containers.